Provider Demographics
NPI:1376392753
Name:MARTIN, ABIGAIL SYLVIA (PA-C)
Entity type:Individual
Prefix:MISS
First Name:ABIGAIL
Middle Name:SYLVIA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 S COLLINS RD STE 800
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4652
Mailing Address - Country:US
Mailing Address - Phone:214-466-6943
Mailing Address - Fax:
Practice Address - Street 1:182 S COLLINS RD STE 800
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4652
Practice Address - Country:US
Practice Address - Phone:214-466-6943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17868363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical